Uterine bleeding is the discharge of blood from the uterus caused by various reasons. It may be due to gynecological diseases, pathology that occurred during pregnancy, childbirth and the early postpartum period. Sometimes bleeding is associated with trauma to the genital organs or diseases of the hematopoietic system.
Not all uterine bleeding requires treatment, because, in fact, menstruation is also uterine bleeding, but in this case it is physiological, not pathological. Menstruation is a regular uterine bleeding that occurs in women who have reached puberty, which develops as a result of rejection of the functional layer of the endometrium. Menstruation is absent until puberty in girls, during pregnancy and some time after childbirth, and also in menopause.
Mandatory treatment requires dysfunctional and obstetric bleeding.
Dysfunctional uterine bleeding is a pathological process that occurs as a result of violations of the functions of the organs responsible for the regulation of the menstrual cycle. There are ovulatory (occurring in women of reproductive age) and anovulatron (occurring in puberty or menopause) dysfunctional uterine bleeding.
Obstetric bleeding is uterine bleeding that occurs during pregnancy, during childbirth and in early postpartum period. These bleedings are dangerous because they begin suddenly, and very quickly there is a large blood loss, which can lead to a violation of vital important functions organism. Treatment of such bleeding is carried out by specialists in obstetric institutions.
If a girl before puberty (10-11 years old) or a woman in menopause the discharge of blood from the genital tract has begun, it is necessary to immediately consult a specialist, since this, in the vast majority of cases, is uterine bleeding. It is more difficult to recognize uterine bleeding in women of reproductive age. Very often, pathological bleeding is regarded as menstruation (which did not start on time, protracted, more abundant), since the signs of these phenomena are similar.
Symptoms of uterine bleeding
In fact, menstruation is also uterine bleeding, but not pathological, but physiological.- Bleeding started in the middle of the menstrual cycle;
- the duration of menstruation is more than 7 days;
- during menstruation, a lot of blood clots come out of the genital tract;
- hygiene products (tampon, pad) are saturated with blood in one hour, and this situation persists for several hours;
- the appearance of weakness, a feeling of fatigue;
- lower abdomen and lower back;
- as a result of a blood test, anemia was diagnosed, which does not have other apparent causes.
Treatment
It is very important to stop abnormal uterine bleeding as soon as possible and correctly, as it can lead to severe anemia and other complications. Therefore, if signs of such bleeding appear, you should immediately contact a gynecologist. It should be noted that the treatment folk remedies permissible, but only after consulting a doctor and with his permission.
With dysfunctional uterine bleeding, hemostatic drugs are prescribed, as well as hormonal agents. hormone therapy may be appointed as emergency measure and as a long-term treatment. The choice of hormonal agents (usually prescribed oral contraceptives) and the scheme of their administration can only be carried out by a doctor. These drugs are needed to restore the disturbed hormonal balance, and their improper use can contribute to the occurrence of new uterine bleeding.
Curettage of the uterine cavity is a procedure performed in women of reproductive and postmenopausal age to quickly stop uterine bleeding. It also allows you to diagnose the cause of the developed pathology. V adolescence and in young women (especially those who have not given birth), curettage of the uterus is carried out according to health indications.
Symptomatic treatment is necessary to eliminate the consequences of uterine bleeding. At heavy bleeding women are prescribed infusion therapy to replenish blood loss. In most cases, it is also justified to prescribe drugs for the treatment of anemia. With severe anemia, it is possible intramuscular injection drugs, with a mild degree of anemia, their oral administration is recommended.
Restorative therapy (immunomodulating agents, vitamins, antioxidants) is also necessary. Often the causes of uterine bleeding are an unhealthy lifestyle, stressful situations, psycho-emotional shocks, therefore, the appointment of sedatives may be necessary.
Which doctor to contact
A woman with uterine bleeding should contact a gynecologist as soon as possible in order to find out its cause and take measures to eliminate it. With intense uterine bleeding, it is necessary to call an ambulance, which will take the patient to a gynecological hospital. Uterine bleeding treated by a gynecologist. Additionally, in severe anemia, a hematologist consultation is required.
is the discharge of blood from the uterus. Most often it is serious symptom diseases female body. Any uterine bleeding should be diagnosed in time, and the woman should receive medical assistance Ignoring similar symptom leads to serious consequences up to and including death. It is important to know that normal uterine bleeding includes only menstruation, the duration of which is up to 5 days, with stable interruptions, 28 days long. All other bleeding is a pathology and requires medical supervision.According to statistics, uterine bleeding, bearing pathological character, in 25% of cases are associated with organic diseases of this organ or ovaries. The remaining 75% are associated with hormonal disorders and diseases of the genital area.
Menstruation (menstruation) is the only physiologically normal type of uterine bleeding. Usually its duration is from three to five days, and the interval between menstruation (menstrual cycle) normally lasts from 21 to 35 days. Most often, the first couple of days of menstruation are not abundant, the next two are intensified and, at the end, again become scarce; blood loss these days should be no more than 80 ml. Otherwise, iron deficiency anemia develops.
In healthy women, menstruation is painless. In case of pain, weakness and a woman should consult a doctor.
The onset of menstruation usually occurs at 11-15 years of age and lasts until the end of the reproductive period (menopause). During pregnancy and breastfeeding menstruation is absent, but this phenomenon is temporary.
It is important to remember that the early appearance spotting in girls (up to 10 years), as well as in women after menopause (45-55 years) is warning sign serious illnesses.
Sometimes spotting in the middle of the cycle (on the 10-15th day after the end) can become a variant of the norm. Their cause is hormonal fluctuations after ovulation: the walls of the uterine vessels become excessively permeable, therefore vaginal discharge may contain blood. Such discharge should not last more than two days. Sometimes the cause of spotting becomes an inflammatory process, so a woman should definitely consult a gynecologist.
A variant of the norm is also implantation bleeding, which occurs as a result of the introduction of the embryo into the uterine wall. This process occurs a week after conception.
Why are uterine bleeding dangerous?
Uterine bleeding has the ability to increase rapidly, not stop for a long time and hard to stop.
Therefore, depending on what type of bleeding a woman has, it can be dangerous with such consequences as:
With moderate but regular blood loss, varying degrees of severity can develop. It begins if the volume of released blood is 80 ml. Although in such conditions there is no direct threat to the life of a woman, however, this process cannot be left without attention.
A large loss of blood may be due to simultaneous heavy bleeding, which is difficult to stop. Most often required surgical intervention, with replenishment of lost blood and removal of the uterus.
The risk of progression of the underlying disease. In this case, we are talking about small blood loss, to which the woman does not pay attention and does not go for medical assistance. At the same time, blood loss, even in a small amount, can eventually lead either to profuse bleeding, or to the fact that the disease that caused it will go into a neglected form.
The danger of bleeding in pregnant women or in women in the postpartum period is that it can end in a state of shock. The intensity and severity of this condition is due to the fact that the uterus is not able to fully contract and stop blood loss on its own.
There are many reasons that can cause uterine bleeding. In order to systematize them, it should be understood that the resulting blood loss can be a disruption in the organ systems, as well as disorders in the genital area.
Extragenital causes of uterine bleeding, that is, those caused by disorders in the work of non-genital organs include:
Diseases of the hematopoietic system, these are: hemophilia, low level vitamin C and K, etc.
Prolapse of the urethra.
Violations in the activity of the cardiovascular system, for example, etc.
Reduced functionality.
The causes of uterine bleeding are genital, in turn, may be associated with the bearing of a child by a woman.
During pregnancy, the following causes of bleeding from the uterus are distinguished:
Ectopic pregnancy.
Pathology of the fetal egg.
The presence of a scar on the uterus.
Placenta previa, its low location or early detachment.
Various processes of destruction of uterine tissues.
Rupture of the uterus during labor.
Injuries birth canal(vagina or vulva).
Infringement or delay of the departed placenta.
Enometritis.
trophoblastic disease.
C-section.
chorionepitheloma.
Genital bleeding can occur in a woman who is not carrying a child. Causes for them include:
Dyscirculatory bleeding, which, in turn, can be climateric, reproductive and juvenile.
Syndrome chronic fatigue, especially enhanced by starvation and exhaustion of the body, can also cause bleeding.
Pronounced hormonal disorders occur during puberty girls, during pregnancy and after childbirth, after abortion.
Sometimes hereditary predisposition and taking certain hormonal pills can affect.
Prolonged bleeding can develop against the background of a medical abortion, which in Lately gaining momentum in popularity.
For the treatment of bleeding caused by hormonal disruptions requires an individual approach. It will depend on the cause that caused bloody discharge from the uterus.
Uterine bleeding after cesarean
After operation caesarean section woman should be under medical supervision. Most often, bleeding lasts a little longer than after childbirth. naturally. This is due to the fact that it is formed on the uterus, which makes it difficult to contract. Normally, bleeding stops completely after a couple of months. If it continues, then the woman needs to report this problem to the doctor.
Cause pathological bleeding after the operation, hemostasis is most often. Therefore, to eliminate this problem, doctors must carefully but carefully scrape the walls of the uterus. If bleeding cannot be stopped, extirpation is required.
If the bleeding is hypotonic, then it is not always possible to stop it, since it occurs after the uterus begins to contract. Profuse blood loss can lead to hypotonic shock. Replenishment of blood supplies by transfusion and manual examination of the uterus are necessary in order to detect possible remains of the placenta, determine the contractile function of the uterus and establish the existing rupture.
The critical measure that doctors take to save a woman's life is the removal of the uterus. This method is used if bleeding after caesarean section by other means (electrical stimulation of the uterus, ligation of blood vessels, administration of uterotonics) cannot be stopped.
Types of pathological uterine bleeding
Gynecologists divide uterine bleeding into many types. But there are those that are most common:
Juvenile bleeding. They are characteristic of the onset of puberty in girls. They can be caused by a number of factors, for example, frequent illnesses, increased physical activity, poor nutrition, etc. Depending on the amount of blood lost, such bleeding can lead to anemia of varying severity.
About profuse uterine bleeding should be said if it is not accompanied by painful sensations. In this case, the volume of fluid lost may vary. There are many reasons, it can be an abortion, and vaginal infections, and taking hormone-containing drugs, etc.
Acyclic bleeding characterized by the fact that it appears in the intervals between menstrual cycles. It can be caused by fibroids, endometriosis and other pathologies. If acyclic bleeding is observed regularly, then a doctor's consultation is necessary. Although this type is not always a symptom of any pathology.
Anovulatory bleeding is typical for women who have entered the period of menopause and for adolescents undergoing puberty. It is caused by the fact that the maturation of the follicles and the production of progesterone are disturbed, in the absence of ovulation. This species is dangerous because, without treatment, it can provoke the development of malignant tumors.
dysfunctional occurs when the functioning of the ovaries is disrupted. hallmark is that it occurs after menstruation has been absent for a long time, and blood loss with it is plentiful.
Hypotonic bleeding occurs due to low tone of the myometrium, after an abortion, etc. most often appears after childbirth.
Dysfunctional uterine bleeding
Dysfunctional uterine bleeding refers to those that are associated with a violation of the production of sex hormones produced by the glands. internal secretion. They can appear at almost any age, both during puberty and during menopause, and in the reproductive period of a woman's life. This pathology is widespread.
This type of bleeding is expressed by the fact that the period of menstruation is lengthened, and the amount of fluid lost increases. Without treatment, it always leads to the development of anemia. The main feature is the prolonged absence of menstruation, sometimes up to six months, and then the occurrence of bleeding, which has a different strength.
Dysfunctional bleeding can be ovulatory (concerns women of reproductive age) and anovulatory (more common in adolescents and premenopausal women). Cycle disorders in this case are expressed in abundant and irregular periods, with long (more than 35 days) and short-term (less than 21 days) intervals, in the absence of menstruation for more than six months.
The tactics of treatment depends on the age of the patient and on the presence of concomitant pathology. It can be either medical or surgical. However, in adolescence, surgery is resorted to only in emergency cases. Conservative therapy is to take hormones. If left untreated, dysfunctional uterine bleeding can lead to miscarriage, chronic anemia, endometrial cancer, state of shock and even death.
Atonic uterine bleeding
Atonic bleeding is characterized by the fact that it is formed when the uterus becomes unable to contract. Lack of contractility in obstetric practice called the uterus of Cuweler. Characteristic atonic bleeding - zero tone and a similar reaction to the introduction of uterotonics.
When it is not possible to stop the bleeding with the help of specialized drugs, a thick suture is applied to the posterior lip of the cervix, clamps are additionally applied to clamp the uterine artery.
If these methods were ineffective, and blood loss could not be stopped, then they are considered as preparation for an operation to remove the uterus. Mass loss of blood is considered to be from 1200 ml. Before completely removing the uterus, attempts are made to ligate the vessels using the Tsitsishvili method, electrical stimulation (this method is becoming less popular, and doctors are gradually abandoning it), acupuncture. It is important to constantly replenish the reserves of lost blood.
This type is characterized by the fact that the tone of the myometrium decreases. Such bleeding occurs when the fetal egg is retained in the uterine cavity, during the separation of the placenta, after its release. The reason lies in the uterus after childbirth, when contractions occur rarely and are spontaneous. The critical degree of such a state is referred to as atony, when contractions are completely absent.
The main tasks facing physicians are:
Stop bleeding as soon as possible.
Replenishment of the BCC deficit.
Avoiding blood loss of more than 1200 ml.
Tracking blood pressure and preventing it from falling to a critical level.
Treatment is aimed at ensuring that the motor function of the uterus is restored as soon as possible. If there are remnants of the fetal egg, then it must be removed either by hand or with a curette. When hypotonic bleeding occurs after childbirth, it is necessary to squeeze out the placenta as soon as possible, if it does not work, then it is removed manually. Most often, it is the removal of the placenta that helps restore the motor function of the uterus. If necessary, her gentle massage on the fist is carried out.
As medicines administration of pituitrin or oxytocin is indicated. Effective in some cases is the imposition of a bubble on the abdomen containing ice or irritation of the uterus with ether. To this end, in posterior fornix a moistened swab is inserted into the vagina. If hypotension does not respond to this therapy, then measures are taken that are characteristic of uterine atony.
Acyclic uterine bleeding
Acyclic uterine bleeding is called metrorrhagia. It is not associated with the menstrual cycle, which is normal, it is characterized by the complete absence of any periodicity.
This condition can occur suddenly and be associated with a woman's pregnancy, incomplete abortion, placenta previa, development ectopic pregnancy, delay of part of the placenta, etc.
Acyclic bleeding, if a woman does not bear a child, can be observed with pathologies such as uterine fibroids, benign tumors. If the tumor is malignant, then metrorrhagia is observed at the stage of its decay.
It is not possible to describe the degree of intensity of blood loss, since the discharge can be spotting, profuse, with and without admixtures of blood clots.
It is important to pay close attention to acyclic bleeding for women who are in menopause, both at its initial stage and several years later, after the cessation of constant menstruation. In no case should they be perceived as renewed ovulation. Metrorrhagia in this period requires careful study, as they are often signs of a malignant process, for example,.
Breakthrough uterine bleeding
Breakthrough uterine bleeding develops against the background of hormonal disorders. They are characterized by an imbalance between estrogen and progesterone. Sometimes this type of bleeding occurs when a woman takes oral contraceptives. In this case, breakthrough bleeding is an adaptation reaction to the drug. If, after taking the prescribed remedy, bleeding occurs that does not correspond to the menstrual cycle, then it is necessary to consult a doctor about adjusting the dose or replacing the remedy.
Breakthrough bleeding can also be observed when the uterine wall is damaged by a spiral. This cannot be ignored, the spiral must be removed immediately.
Most often, blood loss from breakthrough bleeding is minor, however, a visit to the doctor should not be postponed.
Anovulatory uterine bleeding
These bleedings occur during the break between menstruation, their causes are varied, including they can be a manifestation of any disease. Most often, anovulatory bleeding is prolonged in time, lasts more than 10 days, and is acyclic. Women suffer such blood loss either during the extinction of reproductive function, or during its formation.
This bleeding is also called single-phase, during its opening it does not form corpus luteum, the development of the follicle occurs with violations, ovulation is absent.
This bleeding can be hyperestrogenic, when the follicle matures but does not rupture, and hypoestrogenic, when several follicles mature but do not fully mature.
Rarely, anovular uterine bleeding occurs during the reproductive period of a woman's life. Similar phenomena are associated with violations of the hypophozotropic zone, after suffering, poisoning, infections.
Among adolescents, according to statistics, this type of bleeding is quite common. Such disorders account for up to 12% of all gynecological diseases. In this case, malnutrition can be a decisive factor, mental trauma, physiological overload.
Discirculatory uterine bleeding
The occurrence of discirculatory uterine bleeding is caused by impaired ovarian function. Sometimes the impetus is external factors as transferred viral infections, stress, etc. Blood loss is not great, observed after menstruation was absent for a long time.
Often, women observe the presence of clots in uterine bleeding. Most often, doctors explain their appearance by the fact that the uterus during prenatal development, has undergone certain anomalies. Therefore, the blood stagnates in its cavity, forming clots.
Most often, menstruation causes more pronounced discomfort in such women, especially when it occurs with an increased hormonal background. Sometimes it is such a congenital anomaly that can cause increased bleeding and the presence of numerous clots in the discharge.
In addition to the fact that anomalies are congenital in nature, they can be acquired during life. Similar phenomena are associated with the professional characteristics of women and with the abuse bad habits. Often, during menstruation with blood clots, women experience severe cutting pains. In order to exclude the presence of a pathological process, it is important to seek advice from a gynecologist.
Sometimes changes in the hormonal background can also lead to the formation of clots. To clarify the cause, you need to pass a series of tests, including hormones. thyroid gland, and on adrenal hormones, to examine the level of progesterone and estrogen.
The presence of clots severe pain lower abdomen, profuse blood loss during menstruation, acyclic mini-bleeding - all this most often indicates endometriosis. Such a diagnosis is established after a thorough diagnosis and requires appropriate treatment.
Sometimes the cause can be poor blood clotting and some complications that have arisen after childbirth.
Uterine bleeding during pregnancy
The most common causes of uterine bleeding during pregnancy are miscarriage, uterine disease, ectopic pregnancy, and damage to the placenta.
A miscarriage is accompanied by strong cramping pains in the lower abdomen, bleeding is intense, the color of the blood is from bright scarlet to dark. With an ectopic pregnancy, bleeding is accompanied by a deterioration in the general condition, malaise, nausea, and sweating. Blood is dark in color and usually comes out in clots.
Damage blood vessels cervix during pregnancy can occur during intercourse or gynecological examination. This bleeding is usually not heavy or prolonged.
If the placenta is damaged or previa, uterine bleeding may occur in the second or third trimester. The bleeding is usually very heavy. It poses a serious threat to the life and health of the expectant mother and her child.
It should be remembered that uterine bleeding in pregnant women is very dangerous, so a woman must definitely call a medical team that will provide her with urgent assistance.
First aid for uterine bleeding is to call as soon as possible ambulance. This is especially true in the case when a woman is carrying a child, her blood loss is plentiful, her condition worsens sharply. In this case, every minute counts. If it is not possible to call a team of doctors, then it is necessary to take the woman to the hospital on her own.
Any uterine bleeding is a serious threat to life and health, so the reaction must be appropriate.
Categorically, with dysfunctional bleeding, it is forbidden to apply a hot or warm heating pad to the stomach, douche with any compositions, take a bath, use drugs that promote uterine contraction.
Independently, at home until the ambulance arrives, a woman can be helped as follows:
The woman must be put to bed, preferably on her back, and her legs placed on some kind of elevation. To do this, you can put a pillow or a roller from a blanket. Thus, it will be possible to preserve the consciousness of the patient, especially if the blood loss is impressive.
Something cold should be applied to the stomach. If there was no heating pad at hand, then the ice can be wrapped in a regular cloth. You can replace ice with an ordinary bottle filled with cold water. Cold exposure time - up to 15 minutes, then a break of 5 minutes. This will achieve vasoconstriction, and therefore somewhat reduce bleeding.
The woman needs to drink. Since it is not possible to put a dropper at home, you need to offer the patient plenty of fluids. Plain water and sweet tea will do. This will contribute to the loss of fluid along with the blood, glucose will provide nutrition to the nerve cells of the brain.
To the reception medications should be treated with extreme caution, especially if a woman is carrying a child. Before taking them, you should always consult with your doctor, but sometimes it happens that there is no such possibility. Therefore, it is necessary to know the names of hemostatic agents and their minimum dosage. These include Vikasol (taken 3 times a day, at a dosage of 0.015 g), ascorbic acid (maximum daily dose 1g), Dicyon (taken 4 times a day, at a dosage of 0.25), calcium gluconate (1 tablet up to 4 times a day). Before use, it is important to remember that all drugs have side effects.
How to stop uterine bleeding?
When the ambulance arrives at the scene, its actions will be as follows:
A bubble containing ice is applied to the woman's stomach.
If the bleeding is heavy, then the woman should be taken to the car on a stretcher.
Hospitalization of the patient with transfer directly to a specialist.
The introduction of a solution of sulfate, with a threat or the onset of a miscarriage. Or if a spontaneous abortion occurs, the woman is given intravenous calcium chloride, and ascorbic acid diluted with glucose. An injection of Etamzilat can be made.
Hospital doctors use to stop bleeding hormonal preparations, in the event that a woman has not yet given birth, she does not have a suspicion of a tumor. Hormonal drugs include Jeannine Regulon, etc. On the first day they give an increased dose (up to 6 tablets), in the following days one tablet less, bringing up to 1 piece. Sometimes gestogens are used, but it can be used only in the absence of severe anemia.
Hemostatic agents can also be used, for example, Dicinon, Vikasol, Askorutin, Aminocaproic acid.
Sometimes surgery is used, such as curettage of the uterus (an effective method to stop blood loss), cryodestruction (a method without contraindications), laser removal of the endometrium (used in those women who do not plan to have more children).
Treatment of uterine bleeding largely depends on its causes and the age of the patient.
Adolescents are most often prescribed drugs that reduce the uterus, drugs that stop blood and strengthen the walls of blood vessels. It is also recommended to take, herbal medicine, less often - hormonal drugs that regulate the menstrual cycle. Women of reproductive age are prescribed hormonal drugs, sometimes surgical operations(with fibroids, endometriosis of the uterus, etc.) After menopause, uterine bleeding most often indicates oncological pathologies of the uterus and ovaries, so treatment requires mainly surgical intervention, including the removal of the uterus and its appendages.
In treatment, it is most important to diagnose the causes of bleeding in time, so sick women should seek medical help without delay.
Education: Diploma in Obstetrics and Gynecology obtained from the Russian State medical university Federal Agency for Health and Social Development (2010). In 2013, she completed her postgraduate studies at the NMU. N. I. Pirogov.
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every woman needs at least twice a year. In a woman's life, situations often arise when it is necessary to good advice obstetrician-gynecologist, answer to a question, consultation. But even if a woman has no complaints, it must be borne in mind that recently an asymptomatic course has been very common. gynecological diseases, including sexually transmitted infections and gynecological tumors. Even pathological discharge from the vagina with such diseases is not always the case. Without analysis to distinguish them from normal discharge hard. With the latent course of female diseases, there is no abdominal pain, bleeding, menstrual irregularities and other symptoms. Therefore, every woman needs preventive gynecological examinations and basic tests (general blood count, urinalysis, flora and cytology smear), the results of which reveal the presence of hidden asymptomatic gynecological diseases and infections on early stages. The number of preventive gynecological examinations depends on previous diseases and other factors.
When you need good advice from a doctor, you can come to a gynecological consultation at our gynecological clinic, ask the doctor your questions about your health, undergo an initial gynecological examination and, if necessary, further examination and treatment.
Consultation with a gynecologist for early diagnosis of pregnancy
A gynecological consultation and gynecological examination are also necessary for early diagnosis pregnancy. The first signs of pregnancy are inaccurate and often mislead women. During pregnancy, menstrual-like discharge from the vagina is possible, pregnancy tests can be false negative. For an accurate early diagnosis of pregnancy, it is necessary to consult a gynecologist, pelvic ultrasound and determine the level of hCG in a blood test.
good doctor A gynecologist is, first of all, a good diagnostician. Diagnosis of gynecological diseases is based on experience and knowledge. The gynecologist during the initial gynecological examination will determine whether there is a need for more detailed diagnostics, consultations of other doctors. According to the indications, you will receive all the necessary recommendations for treatment and referrals for tests. This will dispel many fears and doubts, notice adverse changes in time. women's health, take measures to correct them, start treatment on time.
A woman is sometimes afraid or ashamed to come to a gynecologist's consultation and gynecological examination. She is frightened by the examination procedure, and even the appearance of the gynecological chair. Nevertheless, even a healthy woman should visit the gynecological clinic twice a year. The main task of the obstetrician-gynecologist of the gynecological clinic is to preserve the health of a woman, which is possible only when carrying out the prevention of gynecological diseases and their timely detection on initial stages. At the appointment with a gynecologist in our gynecological clinic, you will forget about the fear of a gynecological examination. Polite clinic staff do their best to provide you with the necessary medical services quickly and efficiently.
Features of the consultation of a gynecologist. Gynecological examination
Gynecological examination each healthy woman should be held twice a year in order to maintain their health, prevent and detect gynecological diseases in the early stages. To avoid development sexually transmitted diseases, infectious diseases and gynecological tumors, it is better not to postpone a visit to the doctor, but to come for a preventive examination and consultation with a gynecologist.
The gynecologist must know the individual characteristics of your body, all the gynecological diseases that you have suffered. Communication with the gynecologist at the appointment should be easy and trusting. Every woman should have her own obstetrician-gynecologist.
It is advisable to come to a gynecologist's consultation for the first time at the age of 15-16, especially if the girl has not yet begun her menstrual cycle. It is also necessary to come to an appointment with a gynecologist if a woman has already started or plans to start sexual life. Gynecologists advise not only to undergo a preventive gynecological examination twice a year, but also to take basic tests, especially when a new sexual partner appears, to do colposcopy and gynecological ultrasound, because the asymptomatic (hidden) course of gynecological diseases is very common and difficult to diagnose. Many gynecological diseases, if left untreated, can lead to infertility, ectopic pregnancy, or miscarriage.
Stages of gynecological consultation and gynecological examination
Questions for a gynecologist
You can come to a gynecologist's consultation and preventive gynecological examination if there are no complaints or already with certain complaints. A consultation with a gynecologist begins with a conversation. First, the gynecologist asks questions and fills out medical card. By asking questions, the gynecologist will find out with what problem the woman came to the doctor's office. It is important for a gynecologist to know what diseases a woman has had throughout her life, which will tell him about her predisposition to certain diseases. Some questions may seem too intimate or unnecessary, but they must be answered with absolute honesty. Answer all the questions of the gynecologist and do not hesitate to ask him questions, because the state of your health depends on it.
External gynecological examination
A gynecological consultation may include procedures such as pressure measurement, weight determination, examination mammary glands. After that, the gynecologist proceeds to a gynecological examination of the female genital organs. For this, a woman needs to lie down in a special gynecological chair. The gynecologist conducts an external examination in order to identify possible secretions, irritations, rashes, warts, gynecological tumors and other pathological changes in the external female genital organs. Having finished the external gynecological examination, the gynecologist proceeds to the internal gynecological examination.
Internal gynecological examination
During an internal gynecological examination, an obstetrician-gynecologist inserts disposable plastic mirrors into the vagina to examine the cervix. At the same time, the gynecologist also evaluates the presence of secretions and other pathological processes. After removing the speculum from the vagina, the gynecologist conducts vaginal examination. The fingers of one hand, dressed in sterile disposable gloves, are inserted into the vagina by a gynecologist. The gynecologist puts the other hand on the anterior abdominal wall. Thus, the doctor notes the size, shape, position, mobility, soreness of the uterus and appendages, draws attention to the presence of pathological volumetric formations in the small pelvis. If you experience pain during probing, you should immediately inform the gynecologist about this, as this may be a sign of an inflammatory or other gynecological disease. Sometimes a gynecologist may perform a rectal examination (for example, when examining virgins) when other examinations are insufficient.
Taking a smear for flora during an internal gynecological examination
A mandatory step in a preventive gynecological examination should be taking a smear. Bacteriological research- This is a smear examination of gynecological secretions. In a smear, the number of leukocytes is counted and infectious agents are looked for. More than 10 white blood cells in the field of view may indicate the presence of a sexually transmitted infection or inflammation of the female genital organs. According to the results of the smear, fungi (candidiasis), "key cells" ( bacterial vaginosis), a change in the normal flora in the discharge during vaginal dysbacteriosis. The gynecologist prescribes seeding of the discharge and PCR diagnostics of the discharge to clarify the causative agent of the infectious process, if the smear shows the presence of an infection, but does not reveal its pathogen.
Taking a smear for cytology during an internal gynecological examination
A cytological examination (cytology) is an obligatory stage in the early diagnosis of cervical diseases and a mandatory analysis carried out before its treatment. Even if the woman is not bothered by anything and the cervix seems unchanged to the naked eye, the woman should regularly (every year) undergo cytological examination scraping of the cervix. A gynecologist takes a scraping during an internal gynecological examination. Scraping is taken with a little pressure, while scraping off the deeper layers of cells. This painless procedure. This is done because malignant process begins with the lower layers of the epithelium of the cervix and progresses to the surface of the mucous membrane. Therefore, if only the surface layer gets into the analysis, the diagnosis can be made only when the disease is already on late stage development.
Colposcopy
Colposcopy is an examination of the cervix under a special microscope - a colposcope. The gynecologist uses colposcopy in the internal gynecological examination in order not to miss initial signs malignant tumor if the patient is not bothered by anything and the cervix seems unchanged to the naked eye.
Colposcopy is of great diagnostic value for suspected cervical cancer, for diagnostics erosion cervix, dysplasia, leukoplakia. Only extended colposcopy can help to make an accurate diagnosis of cervical disease in the early stages and determine its malignancy.
Extended colposcopy is an examination of the cervix after treatment with a 3% solution of acetic acid. The action of acetic acid lasts about 4 minutes. After studying the collpscopic picture of the cervix treated acetic acid, the gynecologist conducts a Schiller test - lubricating the neck with a cotton swab moistened with 3% Lugol's solution. The iodine contained in the solution stains glycogen in the cells of a healthy, unchanged squamous epithelium necks are dark brown. Thinned cells (atrophic age-related changes), as well as pathologically altered cells in various dysplasias of the cervical epithelium (precancerous conditions) are poor in glycogen and do not stain with iodine solution. Thus, a gynecologist during colposcopy reveals areas of pathologically altered epithelium and, if necessary, designates areas for a biopsy of the cervix.
Ultrasound of the pelvis and fetus
In gynecology, ultrasound of the small pelvis complements the gynecological examination and is used very widely, because. with its help, with a high degree of reliability, it is possible to conduct an examination of the pelvic organs and monitor the development of pregnancy (fetus). Ultrasound of the small pelvis is a method of examination that allows the gynecologist to get an idea about all the organs of the small pelvis, including the uterus and ovaries, which has great value in the diagnosis of gynecological tumors and inflammation of the female genital organs, anomalies in the development of the uterus.
Ultrasound of the pelvis makes it possible to determine the causes of abnormal discharge, uterine bleeding, pain in the lower abdomen and menstrual irregularities that are not visible during a routine gynecological examination.
Ultrasound can determine the presence of pregnancy and abnormalities in the development of the fetus. Also, ultrasound plays a decisive role in the diagnosis of ectopic pregnancy and is always performed before the abortion procedure to confirm the presence of a fetal egg in the uterine cavity.
Consultation with a gynecologist based on the results of a gynecological examination and tests
To make a diagnosis, a gynecologist compares the results of a gynecological examination with anamnesis data (a woman's life and illness history), gynecological tests, complaints, and the results of other examinations. Therefore, in order to make a diagnosis or make sure that there are no gynecological diseases, a woman needs at least two consultations with a gynecologist.
At the first consultation, the gynecologist performs the above-described gynecological examination, colposcopy, pelvic ultrasound, and takes material for gynecological tests. If a woman has complaints and symptoms of gynecological diseases, the gynecologist during the first consultation recommends to the woman what tests (except smears) she needs to pass and prescribes symptomatic treatment to reduce the symptoms of the disease (pain in the lower abdomen, bleeding, itching, etc.).
A woman can pass many tests during the first gynecological examination, but for some tests she needs to come to the gynecologist again for fence material for analysis on a certain day of the menstrual cycle, after the necessary preparation or on an empty stomach.
At the second visit, the gynecologist advises the woman on the results of smears and other tests, if they were taken during the first gynecological examination. The results of the tests may indicate the presence of a gynecological disease in the absence of its symptoms, confirm the preliminary diagnosis established at the first examination, or indicate the need for further examination to make a diagnosis.
A complete treatment regimen for a gynecological disease is signed by a gynecologist after a diagnosis is made. After the treatment, and sometimes during the treatment, a woman needs to come to a gynecologist's consultation and take gynecological tests repeatedly to monitor the results of treatment.
Preparing for a gynecological examination
A woman needs to visit a gynecologist's office several times a year if she cares about her health. For a preventive examination by a gynecologist, the most optimal period is after menstruation. One day before the consultation with a gynecologist, it is not recommended to have sexual intercourse. It is necessary to take a shower before a gynecological examination, but douching has a negative effect, because. the doctor needs to see the real condition of the vaginal secretions and take a swab. You don't need to shave your hair before seeing a gynecologist. If a woman has taken antibiotics and other medications, then it is necessary to warn the doctor about this. Sometimes testing for infections must take place no earlier than two weeks after the end of treatment in order to get correct results. If you have to take tests for chronic infections, then it is better to do this before or immediately after menstruation.
An obstetrician-gynecologist consultation with an examination usually takes about 30 minutes. Try not to be nervous during the inspection. Answer all the doctor's questions and do not hesitate to ask him questions, because. your health depends on it.
It is imperative to visit a gynecologist in the following situations
Recently, the asymptomatic course of gynecological diseases, including sexually transmitted diseases, has been very common. There are vaginal discharges with such diseases, but more often they are the only symptom and appear periodically. Without analyzes it is difficult to distinguish them from normal secretions. Therefore, every woman needs a preventive examination by a gynecologist at least twice a year.
Pathological vaginal discharge is the main symptom of almost all gynecological diseases, including sexually transmitted diseases. When they appear, it is necessary to consult a gynecologist with an examination and analyzes for determining infections, including those transmitted sexually.
Uterine bleeding in the middle of the cycle, increased and prolonged bleeding during menstruation. Gynecological consultation with examination and ultrasound in this case are necessary to determine the source of bleeding. Bleeding that occurs during pregnancy requires immediate hospitalization.
Abdominal pain. In female gynecological diseases, it is most often observed in the lower abdomen. A consultation with a gynecologist with an examination, tests and other examinations are necessary to identify the cause of the pain.
Problems with conception. Conceiving a child requires preparation. Gynecological diseases can adversely affect pregnancy and the unborn baby. Therefore, it is very important to come for a consultation and examination to a gynecologist to identify and cure them before conception.
At pregnancy planning a woman needs to come for an examination and consultation with an obstetrician-gynecologist, be examined and pass in advance analyzes to identify infections, including - ureaplasmosis. Planning for pregnancy and during gynecological examination avoids complications and unpleasant surprises during pregnancy.
Diagnosis of pregnancy. The first signs of pregnancy before a missed period are inaccurate and often mislead women. During pregnancy, menstrual-like discharge is possible. In order to diagnose pregnancy in time, at the slightest suspicion, it is necessary to go to a consultation with a gynecologist, do an ultrasound scan and a blood test for hCG.
Termination of pregnancy (medical abortion). When unwanted pregnancy an obstetrician-gynecologist you will receive qualified advice on its interruption. medical abortion is the least traumatic for a woman.
Contraception. Each woman should choose with the help of a gynecologist the means of protection against unwanted pregnancy that is most suitable for her. This requires a consultation with a gynecologist with an examination, ultrasound, if necessary, a study of the hormonal background and other tests.
Hormonal disbalance. Often the main cause of diseases of the female reproductive system is hormonal changes(hormonal imbalance). At the consultation, the gynecologist will prescribe the necessary examinations for the diagnosis of hormonal disorders.
Menstrual disorders. Ovarian dysfunction is most often a symptom of serious gynecological diseases. Consultation with a gynecologist with an examination is necessary to identify these diseases.
From symptoms of premenstrual syndrome ninety percent of all women are affected. Before menstruation a woman can experience many unpleasant and pain which normally should not exist. A woman should not put up with these feelings and suffer in silence, it is necessary to come for a consultation with a gynecologist.
tides and painful intercourse are the most frequent symptoms menopause. A gynecologist at a consultation will tell a woman how to alleviate the course of a pathological menopause. Very dangerous symptom- the appearance of bloody discharge from the genitals after menopause. When they appear, a woman should come for a consultation with a gynecologist with an examination immediately.
Cervical erosion. One of the most common diseases that may not manifest itself in any way and can be detected only during a preventive gynecological examination.
uterine fibroids. It may also not manifest itself in any way and be detected only during a preventive gynecological examination. Asymptomatic leakage can lead to severe node growth, bleeding and surgical intervention.
endometrial hyperplasia often asymptomatic, but more often manifested by dysfunctional uterine bleeding. Often, the diagnosis of endometrial hyperplasia is made when a woman comes to an appointment with a gynecologist about infertility.
Polyps of the uterus (endometrium) and cervix(cervical canal). V last years polyps of the body of the uterus and cervix are found even in girls adolescence. For a long time they do not manifest themselves in any way and over time can become malignant. For their timely detection, every woman needs a consultation with a gynecologist and a preventive examination twice a year.
Ovarian cyst. At preventive examination on ultrasound, a gynecologist can detect an ovarian cyst in a woman. Some cysts may disappear on their own, but in many cases, a course of hormonal treatment is required, and in some, surgery is also required to get rid of the source of danger.
spikes are formed when an acute inflammatory process in the female genital organs becomes chronic and the healing process stretches over time. Adhesive disease is practically untreatable. Therefore, to avoid the formation of adhesions, when symptoms occur inflammation Go see your gynecologist right away.
cervicitis- inflammation of the mucous membrane of the cervix. May manifest pathological secretions, burning, itching. With a latent course, it may not manifest itself in any way. Therefore, every woman at least twice a year needs a preventive consultation with a gynecologist with an examination. The causative agents of infection are often gonococci, Trichomonas.
Thrush (or vaginal candidiasis) caused by yeast-like fungi of the genus Candida. often acquires chronic course with improper self-treatment. For selection proper treatment and detection of infections that often accompany an exacerbation of thrush, which a woman may not even be aware of (including sexually transmitted ones), it is necessary to come to a gynecologist's consultation with an examination.
Dysbacteriosis of the vagina is a violation normal microflora vagina. This disease suffers most of women, it is often the result of improper self-medication. Dysbacteriosis can lead to the development of inflammatory gynecological diseases. Before prescribing drugs to normalize the microflora of the vagina, a consultation with a gynecologist, examination and tests is necessary.
For examination for syphilis a woman can also come for a consultation and examination to a gynecologist . Syphilis is a chronic venereal disease, which affects the skin, mucous membranes, many internal organs, bones and nervous system. Recently, it often proceeds completely asymptomatically. Used to diagnose syphilis, RW (Wassermann reaction) is often false positive and false negative and is very outdated.
Benefits of Demetra Gynecological Clinic
- Reception is conducted by highly qualified gynecologists with extensive experience
- Given the frequent imitation of gynecological diseases in the pathology of other organs, close cooperation is carried out between gynecologists and the therapist for the benefit of patients
- Modern methods of diagnosis and treatment of diseases, incl. laboratory tests, pelvic ultrasound and pregnancy ultrasound, colposcopy
- Treatment of diseases without hospitalization (outpatient)
- Convenient location of the clinic in Kiev: Darnytskyi district, near Poznyaki metro station
- Convenient opening hours by appointment only
- If you have any questions, call us, our employees will provide all the necessary information
Many female diseases characterized by symptoms such as uterine bleeding . This condition requires immediate medical attention because it is life-threatening and can be fatal. Stopping blood loss is quite difficult due to the variety of reasons by which it could be caused.
The uterus consists of several layers: perimetrium, myometrium and endometrium. The last layer - the endometrium, consists of two balls: the main and functional. Rejection of the functional layer of the endometrium is called menstruation.
But due to a malfunction in the hormonal system of the body, part of it can remain inside along with dilated vessels and glands that begin to bleed. In medicine, this condition is called dysfunctional uterine bleeding.
Categories
Exists a large number of reasons that provoke uterine bleeding, but to simplify medical diagnosis and to simplify understanding, they were divided into two categories: non-genital (disturbances in the organs and systems of the body) and genital (pathologies of the genital area).
The first type includes:
- Infections (measles, influenza, sepsis, typhoid fever);
- Blood diseases (hemophilia, hemorrhagic vasculitis, lack of vitamin C, K, etc.);
- cirrhosis;
- Cardiovascular disorders (atherosclerosis, high blood pressure etc.);
- Malfunctions in the functioning of the thyroid gland.
Causes of uterine bleeding of the second category:
- Discirculatory uterine bleeding (during puberty, puberty, menopause);
- Tumors of the uterus or ovaries;
- Infectious and inflammatory pathologies (cervicitis, erosion, endocervicosis, vaginitis, endometritis);
- Injury to the uterus;
- Rupture of the ovary or its cysts.
Dysfunctional uterine bleeding (DUB)
Normally, during menstruation, the amount of blood loss is 30-40 ml, a maximum of 80. With DMK - more than 100 ml. Dysfunctional bleeding can coincide with menstrual bleeding (abundant and prolonged) or pass independently of them ( different intensity and regularity).
DMC is often observed in women of reproductive age 30-40 years. The main cause of the pathology is expressed in violation of the ovulation process, when the endometrium is not completely rejected.
Often, DMC is quite plentiful, since with hormonal disorder the function of platelets (cells of the coagulation system) decreases, as a result of which the blood liquefies.
A fairly large number of reasons can lead to an imbalance of hormones:
- V puberty, from 12 to 18 years: infections (acute, chronic), hypovitaminosis, physical surge, mental trauma;
- In reproductive age: stress, complicated childbirth and abortion, disruption of work endocrine glands, inflammation of the genital organs;
- With menopause: acute / chronic infections, neuropsychic injuries.
However, it is worth noting that DMC often appears due to a number of other reasons: overweight, blood diseases, certain medications, strict diets, and climate change. But they never occur due to pregnancy or neoplasm.
Symptoms of uterine bleeding
- Dizziness, fainting, general weakness;
- pale skin;
- Nausea, vomiting;
- Fast or weak pulse;
- Lowering blood pressure;
- Discharge of blood from the vagina;
- Large number of blood clots during menstruation. A pad or tampon gets wet quickly, you have to change them every hour or two;
- Menstruation lasts more than 7-8 days (normal 3-8);
- Bleeding after sex;
- Allocations most often do not coincide with menstrual flow.
During puberty, they are usually long, last longer than the established norm, the interval is less than 21 days, blood loss is plentiful (more than 100-120 ml per day).
Bleeding that appears after a delay in menstruation usually speaks of their functional nature.
Fibroids, adenomyosis and blood diseases are characterized by cyclic and very copious secretions.
What to do with uterine bleeding?
The first thing to do is call an ambulance. This is especially true for pregnant women and those cases where the condition worsens very quickly. It is necessary to call an ambulance as soon as possible, because every minute can be decisive.
The second is to consult a doctor on his own, because only a specialist will be able to give an adequate assessment, assessing the condition of the woman and finding out the cause.
Do not: apply warm heating pads, douche, take warm baths, use medical preparations contracting the uterus.
How to stop uterine bleeding:
- Follow bed rest. Legs should be kept in an elevated position, for example, by placing a roller or pillow under them. This will allow the blood to function in the vital important organs(kidneys, liver, brain). With significant blood loss - will reduce the risk of fainting, severe complications;
- Coldness in the lower abdomen. It could be an ice pack wrapped in cloth to prevent frostbite, or a heating pad filled with cold water. Ice is kept for 10-15 minutes, then a 5-minute break is taken. Repeat manipulations for 1-2 hours. Cold constricts blood vessels, thereby reducing bleeding;
- Replenish water balance organism. If it is not possible to put a dropper, drinking plenty of water will help, for example, sweet tea, rosehip broth, water, etc. Water in this case will make up for the loss of fluid that came out with the blood. Glucose nourishes the tissues and, most importantly, the nerve cells of the brain;
- Medicines. They should be taken only after consulting a doctor or in an emergency: Dicinon (0.25 g orally 4 r / d), Calcium gluconate (1 tab. 4 r / d), Aminocaproic acid (30 ml 5 r / d), Vikasol (0.015 g 3 times a day), tincture of nettle or water pepper (100 ml 3 times a day). The above funds increase the activity of the muscles of the uterus, but it is not recommended to take them during pregnancy.
Measures taken in a hospital setting
Some hemostatic agents used for uterine bleeding have already been listed above, for example, Aminocaproic acid, Dicynon. However, in a medical facility, they are administered either intravenously or intramuscularly. At home, these procedures are not performed. Everything should be carried out under the supervision of doctors and medical staff.
Hormonal drugs, such as combined oral contraceptives (monophasic) or gestogens, can be used to stop blood loss. This method is suitable for nulliparous young women who are not at risk of developing tumors in the endometrium.
Also, hormonal agents are used in the case when a woman underwent curettage for diagnostic purposes less than 3 months ago, and at the same time she did not have any pathology in the endometrium.
The second option is hemostatic drugs. In addition to the above, Tranexam is used, as well as Askorutin to strengthen the walls of blood vessels, and to tone the uterus, Ergotal and Oxytocin.
Methods of surgical control of bleeding are also used. The main one and the most effective is the cervical canal. It is carried out for women of reproductive age and during menopause.
For the same purposes, cold treatment, or cryodestruction, is prescribed. With the help of liquid nitrogen, the upper modified layer of the uterus is destroyed. This procedure has no contraindications and gives a stable positive result.
Uterine bleeding is always serious danger for a woman, it can be fatal. Because of this, this symptom should not be ignored, and if a pathology is suspected, it is worth taking immediate action. What types of uterine bleeding are distinguished by physicians? What symptoms do they have? Can you stop blood loss yourself at home? This will be discussed.
In contact with
There are many causes of blood loss, and in each period of life they are provoked different factors. In their practice, doctors divide them into the following types:
If the pathology is not treated, the development of malignant tumors is possible.
- Dysfunctional appearance- main external symptom there will be a failure of the menstrual cycle towards a delay. In this case, bleeding is provoked by a violation of the production of genital female hormones in the endocrine glands.
- Hypotonic- develops due to a decrease in the tone of the myometrium.
- breakthrough view- Occurs when there is a malfunction hormonal system, in the presence of an imbalance between the level of tarragon and progesterone. Blood loss occurs, develops when a woman takes hormonal drugs, such as contraceptives.
Symptoms of pathological blood loss
Sometimes with unspecified menstrual cycle, a woman mistakenly perceives uterine bleeding as regular menstruation. How to distinguish the first from the second? In a relationship common features bleeding, these include:
- dizziness,
- general weakness,
- skin pallor,
- bouts of nausea and vomiting,
- in some cases - fainting, development of hypotension, weak pulse.
How to recognize bleeding from the uterus by local signs:
- bleeding from the vagina,
- during menstruation, they come with a large number of blood clots, which may also indicate a pathology,
- an increase in the period of menstruation, when the latter last longer than usual by 6-8 days.
These signs include and.
Is it possible to stop uterine bleeding on my own?
In case of abnormal development pathological loss blood first aid, before the ambulance arrives, there may be funds from the arsenal of traditional medicine.
What to do, both at home and in a teenager, and in women with menopause before going to the doctor?
Folk remedies:
In addition to the fact that a woman is given a decoction to drink, she is laid in a horizontal position, placing a pillow under her legs, raising them above her body. A cold heating pad or ice pack should be placed on the patient's stomach. Leave for 15 minutes, take a break for 5 minutes and then put the cold on the body again. This technique will narrow the blood vessels and reduce blood loss.
A woman needs to constantly drink and it is definitely worth calling an ambulance if it is not possible to stop blood loss.
In the same way, you can stop uterine bleeding with clots before medical help arrives.
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